Science

Udhayvir Grewal: Much awaited – SANO trial published

Udhayvir Grewal/X

Mar 20, 2025, 10:14

Udhayvir Grewal: Much awaited – SANO trial published

Udhayvir Grewal, Resident Physician at Ochsner LSU Health Shreveport Academy medical centre, shared an article by Berend J van der Wilk, et al. on X:

“Much awaited – SANO trial published.

Phase 3, non-inferiority trial, Netherlands.

Study Overview:

Participants: 309 patients with esophageal cancer with complete response after neoadjuvant chemoradiation (EUS, biopsy, PET).
Groups:
- 198 active surveillance.
- 111 standard surgery.
74% adenocarcinoma.
Median follow-up: 38 months.

Key Findings:

2-year OS for active surveillance (74%) was non-inferior to standard surgery (71%) after modified ITT analysis. Also non-inferior in ITT analysis (75% vs 70%).
OS similar in modified ITT analysis (HR 1.14, two-sided 95% CI 0.74–1.78) or ITT analysis (0.83, 0.53–1.31).
The frequency of postoperative complications and postoperative mortality similar.

Key Questions:

Non-inferiority margin 15% too wide?
Do we need to work towards establishing standard organ-preserving approaches in esophageal cancer?”

Udhayvir Grewal: Much awaited – SANO trial published

Neoadjuvant chemoradiotherapy followed by active surveillance versus standard surgery for oesophageal cancer (SANO trial): a multicentre, stepped-wedge, cluster-randomised, non-inferiority, phase 3 trial.

Authors: Berend J van der Wilk, et al.

Udhayvir Grewal: Much awaited – SANO trial published

Krishan Jethwa, GI Radiation Oncologist at Mayo Clinic, reshared the post on X, adding:

“SANO trial paving the way for much needed consideration of organ preservation for esophagus cancer, including adenocarcinoma.

While the study is exciting, work is still needed as suggested by a substantial regrowth rate and clear room to improve overall outcomes.”

Adenocarcinoma Berend J van der Wilk cancer esophageal cancer fight against cancer Global fight against cancer Krishan Jethwa Mayo Clinic neoadjuvant chemoradiation OncoDaily Oncology RadOnc SANO trial Udhayvir Grewal

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